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June 23, 2016

The sad saga of KP govt’s much-publicised health reforms


June 23, 2016

PESHAWAR: Frustrated by the poor performance of his government in Khyber Pakhtunkhwa, Pakistan Tehreek-i-Insaf chairman Imran Khan gave deadline after deadline for bringing improvement in the public sector hospitals but he could not fulfil his commitment in three and a half years.

He occasionally became emotional and used harsh language while blaming doctors, judiciary and his political opponents for creating hurdles in implementing the much-publicised Khyber Pakhtunkhwa Medical and Teaching Institutions Reforms Act 2015, but never bothered to understand realities behind failure of health reforms.

The Khyber Pakhtunkhwa Assembly unanimously passed the MTI Health Reforms Act in January 2015? but it couldn’t be implemented in the hospitals due to strong resistance from doctors and health workers.

?The last deadline from Imran Khan came on January 31, 2015 in Peshawar.He expressed disappointment over poor performance of the provincial government to implement the MTI Act 2015.

He complained that nobody in the government backed the doctors and the supporting staff who had been supporting health reforms in their respective medical and teaching institutions.After assurances by Chief Minister Pervez Khattak and his team, Imran Khan gave his last three-month deadline to his party’s government.

This deadline has already expired and another three-month period is going to pass after his last commitment but neither MTI Act 2015 was implemented nor patient care improved in hospitals.

In three years, the PTI government has changed one health minister and ?six health secretaries.Dr Nausherwan Burki, the architect of MTI Act 2015 and Imran Khan’s cousin, was given a free hand to implement reforms.

Sitting in the United States, Dr Burki is supposed to spend three days a month and implement the reforms.Some of the doctors opposing MTI Act 2015 even call him the “viceroy of Khyber Pakhtunkhwa” as he is running the 1600 beds largest hospital from America.

He didn’t listen to those who understood the system and sincerely wanted ?the new system to succeed. For one and half years, Dr Burki and Dr Aamir Ghafoor, medical director LRH, tried to impress and convince each other.

Finally, Dr Burki was convinced that Dr Aamir Ghafoor wasted his time and he should have another medical director. He appointed Prof Khalid Mahmood for an interim period if he could implement reforms.

Dr Burki’s first blunder was appointing selection committees comprising faculty members of the same hospital, LRH, for appointment of dean, hospital director and medical director.

In terms of patient care and better management, KTH is good than LRH as its chairman BoG, Dr Faisal Sultan is sitting in Lahore and can be easily approached. And HMC is far better both of LRH and KTH as its chairman Sahibzada Saeed is based in Peshawar and involved in day to day affairs of the hospital.

Prof Burki was informed well before formation of the selection committees that most of the faculty members are having rivalries and grudges and would unnecessarily ?delay the process of appointment of dean, MD and HD.But he didn’t listen and committed another blunder by appointing those faculty members to head   the selection committees who were against the reforms.

The LRH was the first medical and teaching institution that advertised key positions to hire fulltime officials to better run affairs of the hospital.The post of medical director was advertised on January 2 last year while candidates were interviewed on January 28.

According to sources, all members of the selection committee were hospital employees who unnecessarily wasted time and belatedly sent the report to the BoG that only one candidate appeared before the panel.

More time was wasted to decide whether to select the candidate Dr Arshad Javaid or re-advertise the position.Dr Burki decided to re-advertise the position of medical director on February 24. It appeared in newspapers on March 13.

Another mistake Dr Burki committed ?was bringing the much-delayed project of Peshawar Institute of Cardiology (PIC) under the domain of BoG LRH.He was misguided by some of his clever advisors and the project is now pending in the court.

The provincial government should have issued a notification and appointed another project director in place of Prof Dr Hafizullah who has retired from service. He should have appointed a committee under his leadership to turn PIC into reality.

Dr Hafizullah could easily explain why a project launched 10 years ago by the MMA government could not be completed during the terms of ANP-PPP and PTI governments.He may know that the Punjab government launched a similar project, Rawalpindi Institute of Cardiology (RIC) and completed it within 17 months.

They started heart transplants in RIC while Prof Hafizullah and his team could not even complete the building in more than 10 years.Better qualified cardiologists and cardiovascular surgeons from the US, UK and elsewhere in the west had decided to return to Pakistan to join PIC, but Dr Burki’s decision to bring PIC under the BoG LRH was challenged and caused disappointment.

In fact, he made the decision in good faith and wanted to hire competent and foreign-qualified people on merit which some influential people didn’t like.A doctor who isn’t part of the government health sector, Dr Hussain Ahmad Haroon, also a Pakistan Muslim League-Nawaz activist, has challenged PIC and some other good projects, launched by the PTI government, in the court.



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